Lower jaw (mandibular) surgery
Planned surgery to cut and reposition the lower jaw, moving it forward or back to correct the bite and facial balance, almost always combined with a long course of braces.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- It cuts and repositions the lower jaw (usually by BSSO) to correct the bite, and is almost always combined with a long course of braces before and after.
- Numbness or tingling of the lower lip and chin is very common because the feeling nerve runs through the area cut; it is usually temporary but can be permanent.
- It is a major operation under general anaesthetic, with about 3–6 weeks off and a soft diet for several weeks.
- It is available on the NHS for recognised functional problems; results cannot be guaranteed and larger movements carry more relapse and nerve risk.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Corrects a bite that braces alone cannot fix
The bite can be corrected by orthodontics (braces) alone without moving the jaw bone.
Swelling and bruising build up; you are on liquids with pain relief and anti-sickness medicines. Most people go home after 1–2 nights.
Joint follow-up by both the surgeon and the orthodontist over the months after surgery.
Swelling and bruising build up; you are on liquids with pain relief and anti-sickness medicines. Most people go...
Most swelling settles. You continue a soft or liquid diet and keep the mouth very clean. No driving for at least...
Many people return to work or study and to normal food. Lower-lip and chin numbness and subtle swelling often...
Sensation gradually improves in most people. Braces stay on for around six months to finish the bite; avoid...
What is lower jaw (mandibular) surgery?
Lower jaw surgery, or mandibular osteotomy, repositions the lower jaw to correct the bite and the balance of the face. The most common technique is the bilateral sagittal split osteotomy (BSSO), where the jaw is carefully split on both sides so it can be moved forward or back and then fixed with small plates and screws.
Like all jaw realignment surgery, it is part of a long pathway run jointly by an orthodontist and a maxillofacial surgeon. Braces line the teeth up for many months before the operation and continue for around six months afterwards to settle the bite.
It is done mainly to correct a bite that braces alone cannot fix, and to improve chewing, sometimes speech, and facial balance. It does not give a guaranteed cosmetic result.
A nerve that supplies feeling to the lower lip and chin (the inferior alveolar nerve) runs right through the area that is cut, so altered sensation of the lower lip and chin afterwards is very common. It is usually temporary but can occasionally be permanent.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Lower jaw surgery vs braces alone
| Option | What it can do |
|---|---|
| Braces alone | Move teeth within the jaw; cannot reposition the jaw bone |
| Lower jaw surgery | Moves the whole lower jaw forward or back to correct the bite |
| Nerve consideration | The lip/chin nerve runs through the cut, so numbness is common |
| Time involved | Long braces pathway plus a major operation and recovery |
Your orthodontist and surgeon will explain whether your bite genuinely needs the jaw moved, or can be corrected by braces alone.
Preparing for your surgery
- Have a joint assessment with an orthodontist and maxillofacial surgeon, with X-rays, scans, photos and tooth models.
- Expect braces for many months before surgery to line up the teeth (which can temporarily worsen the bite).
- Stop smoking well beforehand, as it impairs bone healing.
- Tell the team your full medical history and all medicines, and complete any pre-operative checks.
- Plan for 3–6 weeks off and a liquid then soft diet for several weeks.
- Arrange a lift home and help for the first days, and protect time for follow-up appointments.
- Ask specifically about your personal risk of lasting lower-lip and chin numbness before you consent.
What happens
The operation is done under general anaesthetic and usually takes around one and a half to three hours. The surgeon works through cuts inside the mouth, so there are normally no cuts on the face.
The lower jaw is carefully split on both sides (the sagittal split), moved into its planned position, and fixed with small titanium plates and screws. The feeling nerve to the lower lip and chin runs through this area and is protected as far as possible, but handling it commonly leaves the lip and chin numb for a time.
Most people stay in hospital for one or two nights. Swelling and bruising peak around the second or third day. You start on liquids, progress to soft foods, and return to a normal diet over about four to six weeks.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- The bite can be corrected by orthodontics (braces) alone without moving the jaw bone.
- The person cannot commit to the long orthodontic treatment before and after surgery.
- Active gum disease, decay or poor oral hygiene that must be treated first.
- A medical condition or smoking habit that makes major surgery or bone healing unsafe.
- Mainly cosmetic or unrealistic expectations not matched by the likely result.
Delay surgery if…
- Facial growth is not yet complete (surgery is usually deferred until growth has finished).
- Gum disease, decay or poor oral hygiene need treating first.
- You are pregnant or planning pregnancy in the near term.
- Smoking has not been stopped, as it impairs bone healing.
- The pre-surgical orthodontic alignment is not yet complete.
Alternatives to discuss
- Orthodontics alone where the problem allows.
- Camouflage orthodontics for a mild discrepancy without surgery.
- Restorative or cosmetic dentistry for minor concerns.
- Accepting the current bite if symptoms are mild and function is acceptable.
- An NHS pathway rather than private treatment.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Corrects a bite that braces alone cannot fix
- Can make chewing and biting more effective and comfortable
- Can help with some speech or breathing problems in selected people
- Improves the balance of the lower face and jaw
- Gives a stable, long-lasting result in most people once healing is complete
Risks & complications
- Numbness or altered feeling of the lower lip and chin (very common early on)
- Marked swelling and bruising, worst around day 2–3
- A soft or liquid diet and difficulty eating for several weeks
- Tiredness and disruption for several weeks
- Numbness or tingling of the lip and chin lasting several weeks before recovering
- The bite not being quite right, sometimes needing a small further operation
- Plates becoming infected and needing removal, usually months later
- Some relapse, particularly after large advancements or setbacks
- Lower-lip and chin numbness lasting more than a year and possibly permanent
- An unfavourable or 'bad' split of the bone during surgery
- Heavy bleeding, or rarely a blood clot in the leg or lung
- Chest infection or other general anaesthetic complications
Because the inferior alveolar nerve runs through the split, altered feeling of the lower lip and chin is the most prominent risk and is very common at first. NHS information puts longer-lasting tingling or numbness (several weeks) at about one in ten people, and changes lasting over a year, which may be permanent, at fewer than one in a hundred. Larger movements carry more nerve and relapse risk. Ask your surgeon about the size of your movement, your personal nerve risk, and how the bite is checked afterwards.
Published figures to discuss
Reported nerve-injury rates after BSSO vary widely between studies because sensation is measured differently and at different times, and because the figure depends on how far the jaw is moved and the technique used. Patient-reported numbness is generally higher than numbness found on objective testing, and most early numbness recovers. Modern techniques report lower permanent nerve disturbance than older ones. The figures below are broad indicators for discussion.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Altered lower-lip/chin sensation lasting several weeks | About 1 in 10 people (around 10%) | Per NHS patient information; most recover over weeks to months. | Cambridge University Hospitals NHS — Jaw or chin corrective (orthognathic) surgerycuh.nhs.ukPublished figure |
| Altered sensation lasting more than a year / possibly permanent | Fewer than 1 in 100 (under about 1%) | Per NHS patient information; relates particularly to lower-jaw surgery. | Cambridge University Hospitals NHS — Jaw or chin corrective (orthognathic) surgerycuh.nhs.ukPublished figure |
| Permanent neurosensory disturbance after BSSO (research series) | Reported widely; recent reviews suggest most early IAN disturbance recovers, with permanent altered sensation usually low single figures | Wide variation reflects measurement method and follow-up; ask your surgeon's own figures. | Guide sourcesClinical context |
| Unfavourable ('bad') split during surgery | Low single figures of operated sides in published series, often around 1–3% | Usually managed at the time; exact rate varies by technique and study. | Systematic review of inferior alveolar nerve injury in bilateral sagittal split osteotomy (PubMed)pubmed.ncbi.nlm.nih.govPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery takes weeks for everyday life but months for full settling. Numbness of the lower lip and chin, swelling and a restricted diet are expected early on, and the orthodontic part continues after the operation.
- Numbness or tingling of the lower lip and chin, improving over weeks to months
- Significant swelling and bruising in the first two weeks
- A soft or liquid diet for several weeks before normal food returns
- Tiredness and feeling 'not yourself' for a few weeks
- Subtle swelling that can take months to fully disappear
Aftercare
- Take pain relief and any anti-sickness or antibiotic medicines as prescribed.
- Keep to the recommended liquid then soft diet and stay well hydrated.
- Keep your mouth scrupulously clean with gentle brushing and any prescribed mouthwash.
- Sleep with your head raised and use cold packs early to ease swelling.
- Avoid smoking, strenuous activity and contact sport as advised.
- Wear elastic bands on the braces exactly as instructed if you are given them.
- Attend all appointments with both your surgeon and your orthodontist, and report worsening numbness.
- Soft and liquid foods and nutritious drinks at home
- Prescribed painkillers, anti-sickness and any antibiotics collected
- A soft toothbrush and any prescribed mouthwash
- Extra pillows and cold packs
- Time off work or study booked (about 3–6 weeks)
- Someone to collect you and help for the first days
- The surgical team's contact number for problems
Scars and how they heal
Lower jaw surgery is usually done through cuts inside the mouth, so there are normally no visible scars on the face. The titanium plates and screws stay in the bone and are not usually felt. Any planned external cut would be discussed with you beforehand.
⚠ Get urgent help if…
- Difficulty breathing or swallowing — seek urgent help
- Heavy bleeding from the mouth that will not stop
- Spreading swelling, redness or pus with fever (possible infection)
- A hot, swollen or painful calf, or sudden chest pain or breathlessness (possible clot) — seek urgent help
- A sudden change in how your teeth meet, or a feeling the jaw has shifted
- Numbness that is worsening rather than slowly improving
- Being unable to keep fluids down or signs of dehydration
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result means the teeth meet correctly, chewing is comfortable, and the lower face is better balanced, with the bite finished by the braces. This is judged over many months as swelling settles and the orthodontics is completed.
Surgery cannot promise a precise cosmetic outcome or that feeling in the lip and chin will fully return. A small amount of relapse can occur, particularly after large movements, which is why retainers and continued orthodontic care matter.
For most people the corrected bite and jaw position are stable and long-lasting once healing and orthodontics are complete, helped by wearing retainers. Some relapse is more likely after large advancements or isolated setbacks. Titanium plates usually stay in permanently and only occasionally need removing.
Combining with other procedures
Lower jaw surgery is combined with orthodontic treatment before and after the operation, and is often done alongside chin surgery (genioplasty) or upper jaw surgery (two-jaw surgery) for more complex problems. Your team will explain how these fit together for your case.
Follow-up & long-term care
You will be reviewed before discharge and then jointly by your surgeon and orthodontist over the following months, often for up to two years, checking healing, the bite, recovery of sensation and the orthodontics. Report breathing difficulty, heavy bleeding, signs of a clot or a sudden change in your bite straight away.
- Wear retainers after the braces come off, as long as advised, to hold the result.
- Keep up excellent oral hygiene and regular dental and orthodontic reviews.
- Tell your team if numbness worsens or your bite changes after treatment.
- Plates are usually left in place; report any plate that becomes tender or infected.
Revision and secondary surgery reality
- Occasionally a second, smaller operation is needed to fine-tune the bite or reposition plates.
- Some relapse can occur, especially with large advancements or setbacks, needing orthodontic or rarely surgical management.
- Plates are usually left in but can be removed later if they become infected or troublesome.
- The final result is judged over many months once swelling settles and orthodontics is complete.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- Joint follow-up by both the surgeon and the orthodontist over the months after surgery.
- Clear written instructions on diet, mouth care, medicines and warning signs, with a named contact.
- A plan to check the bite and to act if it is not quite right.
- Honest tracking of lip and chin sensation recovery, with onward advice if numbness persists.
- Retainer and long-term orthodontic plan to hold the result and limit relapse.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether the lower jaw alone, or the chin and/or upper jaw too, are operated on
- The length and complexity of the operation and the surgeon's and anaesthetist's fees
- Theatre time and length of hospital stay
- The long orthodontic treatment before and after surgery (often a separate, substantial cost)
- Imaging, 3D planning, surgical guides, plates and screws
- Follow-up appointments with both surgeon and orthodontist over up to two years
- Any further surgery to adjust the bite or remove plates
- The surgeon's and anaesthetist's fees and theatre/hospital costs
- The full orthodontic cost before and after surgery, and who provides it
- Imaging, 3D planning and the cost of plates, screws and surgical guides
- The expected number of nights in hospital
- All follow-up reviews with the surgeon and orthodontist
- What happens, and what it costs, if the bite needs adjusting or plates need removing
- The cancellation policy and what is included if a complication occurs
On the NHS? Lower jaw surgery is available on the NHS when there is a recognised functional need that meets local criteria; requests for purely cosmetic reasons are usually private.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Underplaying how common early lower-lip and chin numbness is, and that it can occasionally be permanent.
- Not making clear how long the whole orthodontic-plus-surgery pathway takes.
- Presenting it mainly as a cosmetic 'jawline' procedure with a guaranteed look.
- Not explaining the relapse risk with larger movements.
- No clear plan, or cost on the private pathway, for adjusting the bite or removing plates if needed.
Marketing red flags
- Marketing lower jaw surgery mainly as a cosmetic jawline enhancement.
- Promising a precise, guaranteed facial result.
- Downplaying the long braces pathway or the high chance of temporary numbness.
- Not mentioning that numbness can be permanent.
- Offering surgery before facial growth is complete in younger patients.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- How far will my lower jaw be moved, and in which direction?
- What is my personal risk of lasting lower-lip and chin numbness?
- How long will I be in braces before and after the operation?
- How will you check my bite afterwards, and what if it is not quite right?
- What is the chance of relapse for my movement, and how is it reduced?
- Will the chin or upper jaw be operated on at the same time?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Will my lower lip be numb after the operation?
What is a BSSO?
Can I have it on the NHS?
How long is the recovery?
Will my jaws be wired shut?
Could the jaw move back to where it was?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: Cambridge University Hospitals NHS — Jaw or chin corrective (orthognathic) surgery University Hospitals Plymouth NHS Trust — Orthognathic surgery Maxfacts (UK OMFS patient information) — Jaw disproportion Systematic review of inferior alveolar nerve injury in bilateral sagittal split osteotomy (PubMed) Inferior alveolar nerve injury after sagittal split osteotomy: a literature review (ScienceDirect) Neurosensory disturbance after orthognathic surgery — PMC
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
Related guides: Jaw realignment surgery (orthognathic surgery) · Upper jaw (maxillary) surgery · Treatment of jaw joint disorder (TMJ / TMD) · Cheekbone fracture repair · Cleft lip and palate surgery